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Perianal Crohn's: keeping an eye on the anus

This might seem a little weird at first, but consider that in a case of Crohn's with perianal involvement, your most current and objective data on how things are going is a visual inspection. There is no better way to tell what the current level of inflammation in that region is than taking a look.

What you really want to know on a regular basis is: is the inflammation getting better or worse, and how does that relate to any recent treatments? Taking a quick look regularly can let you know if what you're doing is working or not.

What are you looking for? Swelling/puffyness, lumps, discoloration. You can search for pictures online to compare normal to abnormal.

Prior to diagnosis of course I had no idea about things going on down there, and even after diagnosis I didn't know until several months later when the doctor pointed it out to me. After that, I started keeping an eye on the region (fortunately the kid doesn't really mind) so that I could get a good handle on the direction things were going in. This information was actually extremely useful in determining what was working and what wasn't.

Sometimes it's hard to tell whether things are worse or better. Sometimes it might look a little worse but it's hard to tell whether that's actually inflammation. Just wait some time and take another look--eventually it should be clear. Don't freak out over small changes, but definitely be aware of the week-to-week direction and be prepared to take action if the multi-week direction is bad.

(Current status for my son: things are really healing up down there, and we wouldn't have gotten here without having this data)